Project Summary/Abstract The University of Washington (UW) program trains scientists to perform clinically-relevant research in pulmonary and critical care medicine. In this application, we request 8 slots to support 4 trainees each year as part of a 4-year combined clinical and research program. We focus primarily on physician-scientists who are able to conduct research across the continuum of biomedical investigation, from basic research in the laboratory to translational, patient-oriented and implementation research. An interdisciplinary approach prepares trainees for academic careers characterized by independently funded research and a commitment to training others. The program is distinguished by the quality and expertise of the training faculty, a structured and successful approach to mentoring, and the integration of multiple disciplines and diverse research methodologies leading to outstanding success in training independent scientists. Research training is conducted through two primary pathways: Basic Science and Health Outcomes. Within each pathway, experienced and committed mentors provide a rich range of research opportunities, research study groups expose the trainee to a broad range of methodologies and research topics, and didactic course work enriches the research training experience. The Basic Science pathway provides trainees with the opportunity to master a wide variety of cutting edge research methodologies. The Health Outcomes pathway generally includes completion of a master's degree in either the Department of Epidemiology or Health Services. Training in translational research occurs at the confluence of the two pathways. Our success in training physician- scientists is founded on a highly structured, yet flexible process to aid fellows in selecting research mentors and projects and guide them through the mentoring process. Prior to beginning research training, trainees 1) are counseled by training faculty leadership, 2) participate in a senior fellow-driven research symposium and 3) have dedicated ?sabbatical weeks? each fall and spring to conduct interviews with potential mentors. Once in the research training program, formal mentoring committees support and track the fellows' progress. Training includes instruction in manuscript and grant writing and a formal review process for grants and research presentations. A series of evaluation metrics monitor progress of the trainees, mentors, and program leadership. We have developed and articulated core principles of mentoring that are used to guide and evaluate training. Through a commitment to continuously review and improve our program, the training program has kept pace with advancing biomedical research and the changing needs of our trainees. Over the past 15 years, we have retained nearly 60% of our physician-scientists in full-time academic positions, and our trainees perform exceptionally well compared to other DLD-supported T32 programs, with nearly double the number of K- and R-awards per trainee.